tbuckley/cabot-search huggingface dataset:
Treatment patterns and outcomes in prostate cancer patients tested with Decipher in SEER.
Authors: Nicholas George Zaorsky, James Alexander Proudfoot, Randy Vince, Yang Liu, Vinnie YT Liu, Raed Zuhour, Angela Y Jia, Yilun Sun, Jim C. Hu, Jonathan Evan Shoag, Edward M. Schaeffer, Elai Davicioni, Valentina I. Petkov, Daniel Eidelberg Spratt
Journal: Journal of Clinical Oncology (2022)

e17006 Background: In 2021, national data between the Decipher 22-gene prognostic gene expression classifier (GC) for men with prostate cancer and the Surveillance, Epidemiology, and End Results (SEER) cancer registries were linked. The purpose of the work is to report on the linkage by characterizing national GC usage and its association with treatment decisions for men with prostate cancer. Methods: Patients in the SEER registries with primary prostate cancer diagnosis from 2010 to 2018 were included and linked to data from GC testing conducted between 2014 to 2020 (Veracyte, San Diego, CA). GC scores (range 0-1) and GC risk groups (low, intermediate, and high) were used for continuous and categorical analyses. Multivariable logistic regression was used to quantify the association between GC and active surveillance and watchful waiting (AS/WW) use and adverse pathology at radical prostatectomy (RP). Adverse pathology was defined as pathological grade group ≥3, pathological stage ≥pT3b, or lymph node invasion. Results: A total of 575,363 patients were eligible for analysis, of which 10,528 patients underwent GC testing (5,015 GC biopsy test, and 5,513 GC RP test). The median age was 67 for both tested and untested, but more white patients underwent testing (82% vs 76%, p &lt; 0.001). For GC biopsy tested patients, AS/WW was highest for those with GC low risk results (41%) as compared to those with intermediate (32%) or high (17%) GC risk (p &lt; 0.001). RP rates were lower in the tested compared to untested (25% vs. 36%, p &lt; 0.001), and among the tested patients, RP use increased by GC risk group (19% of low, 25% of intermediate, and 34% of high GC risk, p &lt; 0.001). A similar trend by GC risk group in management for radiation therapy was observed (13% of low, 19% of intermediate, and 29% of high GC risk, p &lt; 0.001). In a multivariable logistic regression adjusted for age, race, NCCN risk group, and year of diagnosis, GC tested patients were more likely to undergo AS/WW compared to untested (OR 2.9 [95% CI, 2.8-3.1], p &lt; 0.001). Within the subset of patients classified as NCCN low/favorable intermediate risk at biopsy and who were subsequently treated with RP (n = 594), GC high risk (&gt; 0.6) was associated with more than 3 times the odds of harboring adverse pathology (OR 3.2 [95% CI 1.6-6.4], p &lt; 0.001). Conclusions: Using the first ever linked SEER-Decipher data, we demonstrate that population-based treatment patterns are independently associated with GC test results. Patients with lower GC scores are independently more likely to undergo AS/WW; those with higher scores are more likely to have adverse pathology at time of RP.
Transcorporal vs. bulbar artificial urinary sphincter implantation in male patients with fragile urethra
Authors: M. El Akri, I. Bentellis, T.T Tricard, T. Brierre, T. Cousin, H. Dupuis, N.H Hermieu, V. Gaillard, B. Poussot, D. Robin, A. Pitout, P. Bertrand-Leon, D. Chevallier, F. Bruyere, X. Biardeau, H. Monsaint, L. Corbel, C.S Saussine, J.FH Hermieu, P. Lecoanet, G. Capon, J-N. Cornu, X. Game, A.R Ruffion, B. Peyronnet
Journal: European Urology (2022)
N-antigenemia detection by a rapid lateral flow test predicts 90-day mortality in COVID-19: A prospective cohort study
Authors: Raquel Almansa, Jose María Eiros, David de Gonzalo-Calvo, Tamara Postigo, Alicia Ortega, Raul Lopez-Izquierdo, Anna Moncusí-Moix, Clara Gort-Paniello, Marta Dominguez-Gil, Amanda de la Fuente, Laura González-González, Tania Luis-García, Nadia García-Mateo, Ana P. Tedim, Fátima Rodríguez-Jara, Noelia Jorge, Jessica González, Gerard Torres, Oliver Norberto Gutiérrez-Pérez, Maria José Villegas, Sonia Campo, Eva Ayllon, Tomás Ruiz Albi, Julio de Frutos Arribas, Ainhoa Arroyo Domingo, Jesica Abadia-Otero, Julia Gómez Barquero, Wysali Trapiello, Luis Javier Garcia Frade, Luis Inglada, Felix del Campo, Jesús F. Bermejo-Martin, Ferran Barbé, Antoni Torres
Journal: Clinical Microbiology and Infection (2022)
Robot-assisted radical nephrectomy and inferior vena cava level I-III thrombectomy: Perioperative and mid-term oncologic outcomes
Authors: U. Anceschi, L. Misuraca, A. Brassetti, M.C. Ferriero, G. Tuderti, R. Mastroianni, A.M. Bove, M. Costantini, S. Guaglianone, G. Cacciamani, M. Aron, M. Desai, I.S. Gill, M. Gallucci, G. Simone
Journal: European Urology (2022)
MODL-05 Metronomic Intrathecal Delivery of CDK4/6 Inhibitors in Preclinical Models of Pediatric Brain Tumors
Authors: Sergio Guadix, Brice Martin, Madeline Laramee, Nadia Dahmane, Craig Thomas, Mark Souweidane
Journal: Neuro-Oncology (2022)

Abstract INTRODUCTION: CDK4/6 inhibitors have shown promise against central nervous system (CNS) tumors in vitro. This class of drugs relies on long-term exposure. Their use in early phase clinical studies in children with CNS tumors has defined dose limitations due to systemic toxicity. We have sought to circumvent these limitations in using CDK4/6 inhibitors for pediatric CNS tumors by first demonstrating enhanced efficiency with long-term administration and exploiting prolonged intrathecal delivery (IT). METHODS: Pediatric CNS tumor cell lines were used for cell viability assays: ATRT (BT-12, BT-16), CPC (CCHE-45), diffuse midline glioma (DIPG-XIII, HSJD-007), and medulloblastoma (DAOY); the assays were conducted at 24h, 72h, and 7d post-administration of CDK4/6 inhibitors (abemaciclib, palbociclib, ribociclib). Half maximal growth inhibitory concentrations (GI50) and areas under the curve (AUC) were compared for short-term (24h, 72h) and long-term (7d) dose-response curves. Toxicity with chronic IT administration was assessed using a neurobehavioral safety profile of 7-day continuous infusion of 2.5mM palbociclib (n = 5) into the mouse lateral ventricle compared with vehicle (n = 4). RESULTS: Our results demonstrate increased CDK4/6 inhibitor potency with longer administration. The greatest reductions in short-term to long-term GI50 were observed in ATRT, CPC, and DIPG across all inhibitors. The most pronounced time-dependent efficacy was observed with palbociclib for ATRT and abemaciclib for CPC and DIPG. AUCs significantly decreased (P &amp;lt; 0.05) with increasing drug exposure time across all inhibitors. 7-day intraventricular palbociclib infusion was equivalent in safety to PBS at doses ranging from 1,000 to 10,000-fold the in vitro GI50. CONCLUSIONS: The efficiency of CDK4/6 inhibitors in pediatric CNS tumors is enhanced with prolonged exposure. Long-term IT administration can achieve high CNS doses without associated systemic toxicities. Translational efforts using a metronomic IT strategy are logical to explore for pediatric CNS tumors which have potential for a leptomeningeal disease pattern.
Effect of Psychiatric Advance Directives Facilitated by Peer Workers on Compulsory Admission Among People With Mental Illness
Authors: Aurélie Tinland, Sandrine Loubière, Frederic Mougeot, Emmanuelle Jouet, Magali Pontier, Karine Baumstarck, Anderson Loundou, Nicolas Franck, Christophe Lançon, Pascal Auquier, Lee Antoine, Elsa Castot, Nicolas Grand Ordener, Julien Grard, Juliette Robert, Antoine Simon, Aurélien Troisoeufs
Journal: JAMA Psychiatry (2022)

Reducing the use of coercion in mental health care is crucial from a human rights and public health perspective. Psychiatric advance directives (PADs) are promising tools that may reduce compulsory admissions. Assessments of PADs have included facilitation by health care agents but not facilitation by peer workers.To determine the efficacy of PADs facilitated by peer workers (PW-PAD) in people with mental disorders.A multicenter randomized clinical trial was conducted in 7 French mental health facilities. Adults with a DSM-5 diagnosis of schizophrenia, bipolar I disorder, or schizoaffective disorder who had a compulsory admission in the past 12 months and the capacity to consent were enrolled between January 2019 and June 2020 and followed up for 12 months.The PW-PAD group was invited to fill out a PAD form and meet a peer worker who was trained to assist in completing and sharing the form with relatives and psychiatrists.The primary outcome was the rate of compulsory admission at 12 months after randomization. The overall psychiatric admission rate, therapeutic alliance, quality of life, mental health symptoms, empowerment, and recovery outcomes were also investigated.Among 394 allocated participants (median age, 39 years; 39.3% female; 45% with schizophrenia, 36% bipolar I disorder, and 19% schizoaffective disorder), 196 were assigned to the PW-PAD group and 198 to the control group. In the PW-PAD group, 27.0% had compulsory admissions compared with 39.9% in the control group (risk difference, -0.13; 95% CI, -0.22 to -0.04; P = .007). No significant differences were found in the rate of overall admissions, therapeutic alliance score, and quality of life. Participants in the PW-PAD group exhibited fewer symptoms (effect size, -0.20; 95% CI, -0.40 to 0.00), greater empowerment (effect size, 0.30; 95% CI, 0.10 to 0.50), and a higher recovery score (effect size, 0.44; 95% CI, 0.24 to 0.65), compared with those in the control group.Peer worker-facilitated PADs are effective in decreasing compulsory hospital admissions and increasing some mental health outcomes (self-perceived symptoms, empowerment, and recovery). Involving peer workers in the completion of PADs supports the current shift of mental health care from substitute decision-making to supported decision-making.ClinicalTrials.gov Identifier: NCT03630822.
Hospitalization and post-discharge survival outcomes of adolescents and young adults with cancer.
Authors: Felippe Lazar Neto, Cassio Murilo Trovo Hidalgo Filho, Joao Wilson Da Rocha, Renata Colombo Bonadio, Paulo Marcelo Hoff
Journal: Journal of Clinical Oncology (2022)

e18687 Background: Cancer incidence has increased among adolescents and young adults (AYA) over the last two decades. Younger patients often present with late diagnosis, aggressive disease, and are more likely to receive chemotherapy during cancer treatment. We investigated admission outcomes and post-discharge survival of AYA who were hospitalized after urgent admission. Methods: Retrospective cohort of patients with solid tumor diagnosis and age between 18 and 39 years, hospitalized after urgent admission to a tertiary, publicly-funded, cancer hospital in São Paulo, Brazil, from February 1st to December 31th 2021. We excluded patients with positive COVID-19 RT-PCR. We collected data on gender, cancer diagnosis, length of hospital stay, in-hospital mortality, chemotherapy infusion either before and during hospitalization; and last-follow up date and status. AYA admissions were compared to older adults (≥ 40 years [non-AYA]) admissions with chi-squared test. Overall survival (OS) after discharge between groups was analyzed with the log-rank test. Results: Of 4011 admissions, 312 were AYA. The median age was 34 (IQR 29-38) and most patients were female (63%). Compared to older adults (N = 3699), a higher proportion of AYA patients had breast cancer (25% vs 15%), central nervous system cancer (8.4% vs 2.6%), cervical cancer (12% vs 2.7%) and germinative cancer (4.5% vs 0.3%). The median length of hospital stay was 6 days (IQR 4-10). AYA were more likely to be under chemotherapy treatment during (11% versus 4%, p = 0.001) and within 30 days before hospitalization (32% vs 20%, p = 0.001). The overall in-hospital mortality rate was lower among AYA compared to older adults during the same period (12% vs 20%, p = 0.01). However, of those who died, a higher proportion were prescribed chemotherapy infusion before (38% vs 19%, p = 0.004) and during (15% vs 3.3%, p = 0.003) hospitalization; and a higher number of patients deceased on intensive-care unit beds, although the difference was not statistically significant (46% versus 36%, p = 0.2). Despite similar rates of 30-days readmissions (29% versus 26%, p = 0.3), AYA had better prognosis after discharge (mOS 295 days versus 181 days, p = 0.002). Conclusions: AYA patients had better hospitalization outcomes and were more likely to receive aggressive care near the end of life. Despite similar rates of early (≤ 30 days) readmissions, AYA had higher median overall survival after discharge compared to older adults. These finding should be taken into consideration when discussing hospitalization goals during admission of AYA with cancer.
Immune-related gene set prediction model contributes to the evaluation of prognosis in lung adenocarcinoma patients.
Authors: Liwen Zhang, Yang Liu, Leilei Lu, Dong You
Journal: Journal of Clinical Oncology (2022)

e20550 Background: In recent years, rapid progress of immunotherapy (I/O therapy) development brings new hope to LUAD patients. The subtypes and/or quantality of TIL-IC cells were closely related to the prognosis and to the I/O therapy’s response in patients with a variety of solid tumors. In order to stratify high-risk and low-risk LUAD patients, we herein established a prognostic prediction model based on the expression of large-scale immune infiltration genes in LUAD patients. Methods: RNA sequencing data and relevant clinical information of LUAD patients ( n = 501) were obtained from the TCGA cohort. Stromal and immune scores were calculated using ESTIMATE algorithm. The differentially expressed immune-related genes (IRGs) were identified using the “DESeq2” package in R platform. Patients were randomly divided into training set and validation set with a ratio of 8:2. Univariate and Lasso Cox regression analyses were performed to identify overall survival (OS)-related IRGs. Next, stepwise multivariate Cox regression analysis was carried out to establish an optimal risk model of immune-related prognostic gene sets in the training cohort. Kaplan-Meier curves and receiver operating characteristic (ROC) curves were used to examine the predictive performance of the model in the validation cohort. Results: A total of 643 IRGs were identified in these LUAD patients, of which 140 IRGs were significantly associated with OS by univariate Cox regression analysis (P &lt; 0.05). Lasso Cox and stepwise multivariate Cox regression analysis identified IRGs as independent prognostic factors, including C20orf197, SPRR1B, CHRNA5, SLC14A2, RP11-284F21.9, IGLV9-49, IGF2BP1, and C5orf64. The final immune-related gene set model was as follow: risk score = −0.13 * expression level of C20orf197 + 0.074 * expression level of SPRR1B + 0.23 * expression level of CHRNA5 − 0.11 * expression level of SLC14A2 + 0.11 * expression level of RP11-284F21.9 - 0.076 * expression level of IGLV9-49 + 0.048 * expression level of IGF2BP1 - 0.42 * expression level of C5orf64. Patients were divided into high-risk group and low-risk group with the median risk score. Kaplan–Meier survival analysis showed that the high-risk group had a significantly poor prognosis, when compared to the low-risk group in the training set ( HR 2.77, 95%CI; [1.96 - 3.93], P &lt; 0.0001). The ROC curve analysis equally revealed that the area under curves for OS in the first and fifth year were 0.82 and 0.81, respectively, in the validation cohort. Taken together, the eight IRGs risk prediction model could effectively stratify LUAD patients according to prognosis. Conclusions: We constructed a prognostic prediction model for LUAD patients, which consisted of a robust signature of eight IRGs. This model could effectively stratify high-risk and low-risk LUAD patients and help to customize personalized treatment plans.
Diagnostic Traps—Noteworthy Electrocardiogram Patterns
Authors: Hao Wang, Xiao-Ce Dai, Chuan-Hai Zhang
Journal: JAMA Internal Medicine (2022)

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Nodal surveillance and adjuvant therapy in sentinel lymph node-positive melanoma patients.
Authors: Elise Kornreich Brunsgaard, Elliot Amponsah Asare, Tawnya Lynn Bowles, John Robert Hyngstrom
Journal: Journal of Clinical Oncology (2022)

e21586 Background: Since the publication of the Multicenter Selective Lymphadenectomy Trial-II (MSLT-II) in 2017, completion lymph node dissection (CLND) for sentinel lymph node (SLN)-positive patients has mainly been deferred for ultrasound surveillance of the nodal basin. Additionally, there is now widespread use of adjuvant therapy in these patients. However, CLND was required for the major adjuvant therapy trials, therefore information on recurrence patterns in SLN-positive patients receiving adjuvant therapy without CLND is limited. Methods: In this retrospective cohort study of patients with SLN-positive melanoma identified from 2017 to 2021 at a single institution, the primary aim was to evaluate the incidence of local, nodal, in-transit, and distant recurrence in patients receiving adjuvant therapy with nodal surveillance compared to nodal surveillance alone. Method of detection of recurrence, compliance with ultrasound surveillance, and clinicopathologic risk factors were also assessed. Chi-square tests were used to evaluate for any associations between clinicopathologic characteristics, initial location of recurrence, and receipt of adjuvant therapy. Results: Of 157 SLN-positive melanoma patients identified, 21 (13%) received CLND and 13 (8%) had insufficient follow-up information for inclusion. Among 123 eligible patients (mean 55 years, 54% male), the median follow-up time was 24.5 months during which 33 (27%) patients recurred. Of 13 patients with isolated nodal recurrence, three were detected by ultrasound alone, five were detect by CT alone, and five were detected by both CT and ultrasound (Table). 90 (73%) patients in the cohort received adjuvant therapy (92% anti-PD1, 6% BRAF/MEK, 2% anti-CTLA4). The main reasons for exclusion of adjuvant systemic therapy were minimal nodal disease or patient refusal. The average time to recurrence was 13.4 months. There were no significant differences in recurrence rates (p = 0.49) or location of initial recurrence (p = 0.64) by receipt of adjuvant therapy. 29 (24%) patients missed more than one ultrasound. Ultrasound surveillance was most frequently missed due to clinician omittance or patient distance to clinic. Conclusions: In our cohort of SLN-positive melanoma patients, the majority received adjuvant anti-PD1 immunotherapy and were followed in surveillance without CLND. There was no significant difference in recurrence patterns based on receipt of adjuvant therapy and a quarter of nodal recurrences were detected by ultrasound alone. Our results support the use of ultrasound surveillance in addition to cross-sectional imaging to monitor for recurrence in these high-risk patients.[Table: see text]
Secukinumab is effective in the treatment of recalcitrant palmoplantar psoriasis and palmoplantar pustular psoriasis in a daily practice setting
Authors: Alejandra Reolid, Susana Armesto, Antonio Sahuquillo-Torralba, Tiago Torres, Rosa Feltes, Eva Vilarrasa, Isabel Belinchón, Pablo de la Cueva, Lourdes Rodríguez, Alberto Romero-Maté, David Vidal, Pablo Coto-Segura, Enrique Herrera-Acosta, Josep Riera-Monroig, Laura Salgado, Mar Llamas-Velasco, Esteban Daudén
Journal: Journal of the American Academy of Dermatology (2022)
Examining disparities in cancer pain-specific clinical trials.
Authors: Mark Sueyoshi, Tiarrah Salvi-Jackson, Utkarsh Shukla, Damian Archer, Kathryn Huber
Journal: Journal of Clinical Oncology (2022)

e18513 Background: Clinical trials overall have been found to lack proportional representation of minority patient populations. This limits their generalizability as well as progress towards equitable care. This work examines the racial representation of cancer pain related clinical trials in the United States. Methods: All trials with posted results that had started between 1999 to 2019 on ClinicalTrials.gov were examined, excluding trials that included sites that were not within the United States and trials without demographic results posted on ClinicalTrials.gov. We calculated enrollment fractions (EFs) for each group as defined by the Surveillance, Epidemiology, and End Results (SEER) database cancer prevalence by race. Results: As of February 10, 2022 there were 340 trials on ClinicalTrials.gov which were categorized as “Cancer Pain” related. 84 of these studies had posted results. An additional 19 were excluded due to having non-US sites and 31 were excluded due to absence of demographic data, leaving at total of 34 studies for this evaluation (n = 2,767 patients). Examination of clinical trial enrollment was separated by decade (1999-2009 and 2010-2019), utilizing available SEER cancer prevalence by race data for 2009 (as a comparator for 1999-2009) and most recent available 2018 data (as a comparator for 2010-2019). Total enrolled patients in cancer-specific trials between 1999-2009 was 817; 85.1% white, 7.6% black/African American, 1.8% Asian/Pacific Islander. When compared to the SEER 2009 prevalence for all cancer, the EF was 97.5%, 91.6%, and 83% for white, black and Asian groups respectively. Between 2010-2019 there were 1950 enrolled patients, 85.6% white, 9.9% black/African American, 2.1% Asian/Pacific Islander. When compared to the SEER 2018 prevalence for all cancer, the EF was 101.2%, 102.1%, and 61.8% for white, black and Asian groups respectively. Conclusions: In the examination of racial representation within cancer pain-specific trials relative to all cancer prevalence between 1999-2009 and 2010-2019, there appears to be a slight increase in relative representation of white participants (+3.7%), and an even greater increase in representation of black/African American participants (+10.5%). Asian/Pacific Islanders had a notable drop in relative representation (-21.2%). This data is suggestive that minority representation in cancer-pain specific trials has become more representative with regards to black/African Americans. However, there is a large relative decrease in Asian/Pacific Islander representation in cancer pain-specific trials. Given the importance of cancer pain management, it is vital that we move toward equitable accrual to these clinical trials such that they that accurately reflect racial groups in the United States population.